EBV viral load + CMV PCR mandatory; EBV-driven PTLD (most cases) responds to rituximab ±...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-PTLD-INFECTION-SCREENING`
Type	Red flag
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	`DIS-PTLD`
Sources	`SRC-ESMO-DLBCL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	EBV viral load + CMV PCR mandatory; EBV-driven PTLD (most cases) responds to rituximab ± chemo; EBV-negative PTLD often requires chemo upfront.
Clinical direction	investigate
Category	infection-screening

Trigger Logic

{
  "any_of": [
    {
      "finding": "ebv_pcr_blood_positive",
      "value": true
    },
    {
      "finding": "cmv_pcr_blood_positive",
      "value": true
    },
    {
      "finding": "ebv_status_tumor",
      "value": "positive"
    }
  ],
  "type": "biomarker"
}

Notes

EBV status determines whether monotherapy rituximab + IS-reduction has high response chance vs requiring R-CHOP-like chemo upfront. Flag drives MDT discussion + indication selection downstream.

Used By

Algorithms

ALGO-PTLD-1L - ALGO-PTLD-1L